Applying the "Do No Harm" Principle to Health Policy

Commentary by John C Goodman

January 23, 2007

"First, do no harm." This principle is well-known to physicians as part of the Hippocratic Oath. No similar oath is taken by politicians, of course. But suppose they did. Suppose that before they pass any new health legislation, our political representatives were required to reexamine existing laws and make sure that government is not the cause of the very problems it attempts to solve. What would our health care system look like?

Health economists at the National Center for Policy Analysis set out to answer that question recently. They began by identifying five major choices people make and isolating five ways in which public policies interfere with those choices—perversely encouraging people to make socially undesirable decisions. They then sought to determine what our health care system would look like if government policy were at least neutral. What follows is a summary of that analysis, along with some rather surprising conclusions.